Struggling to contain a growing measles outbreak that started at Disneyland a month ago, Orange County health officials ordered about two dozen high school students without proof of immunization to stay away from campus.

The students were ordered out of class after they learned a Huntington Beach High School student who was infected with measles came to class when school resumed after winter break.

"If there is a case in the school and their child is not immunized, they will be removed from the school for 21 days," said Orange County's public health officer.

"Once again, we are off to a bad start in 2015 ... As of today the number of cases has risen to 59 confirmed cases in California." [Gil Chavez]

1/21/2015 9:41:52 PMAmy.Hubbard

"With this outbreak in the state, we can expect to see many more cases ... We must do e4verything possible to limit the disease fro spreading. ... I am asking unvaccinated Californians to consider" getting vaccinated. Chavez cited the responsibility to young unvaccinated children.

1/21/2015 9:43:37 PMAmy.Hubbard

Question: "Some of the cases are in people who have been vaccinated. Why is that?"

1/21/2015 9:44:58 PMAmy.Hubbard

Chavez: "The vaccine is 99% effective" So it's the 1% of the population who are susceptible.

1/21/2015 9:46:06 PMAmy.Hubbard

59 cases -- 50 of those were unvaccinated, and nine were vaccinated -- the "vaccine failures" were among the 1% who are susceptible

1/21/2015 9:46:31 PMAmy.Hubbard

Question: What will finally shatter the myth that the measles vaccine is dangerous?

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Answer from epidemiologist Gil Chavez: People "trivialize" what is a very serious illness. Others are uninformed and believe the vaccine is unsafe.

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Some schools in California have an opt-out rate for vaccinations as high as 30%

1/21/2015 9:53:17 PMAmy.Hubbard

Question: For those people who have only had one measles vaccine shot, should they consider getting a second shot?

"Anyone who has had only one dose ... can get another dose" or have a blood test to see if they are covered. It's also perfectly safe to get a third dose of vaccine. [Kathleen Harriman, head of the CDPH vaccine preventable disease epidemiology section

1/21/2015 9:55:18 PMAmy.Hubbard

Question: Do we know about the first measles case in California? Where did they get the illness?

Chavez: "The issue about the first case is one of those mysteries that we may never solve. ... Measles doesn't circulate in California normally. The only way we have it in the state is through ... someone who travels and comes home or an international visitor."

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Harriman: "It's very unlikely we will ever identify who the index case was."

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Question: What is actually happening on the ground? What are health officials doing to prevent the spread?

Harriman answers that when health officials first hear about a case that's confirmed, they try to identify anyone who had contact with that person. Sometimes measles patients have two or three visits to a doctor before they're diagnosed -- those visits can "easily translate to hundreds of contacts"

Officials undertake a quick and intense effort to contact those people who have had contact with the infected individual. They try to identify if they are immune to measles. Some who have been exposed can be given medicine after the fact that can help.

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Unvaccinated healthcare workers can help spread the disease.

Harriman notes: Most hospitals do a good job of making sure all healthcare workers are innoculated. Smaller clinics don't always do so.

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Question: What's the date of the most recent diagnosis from Disneyland outbreak?

Answer: Jan. 18.

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Is Disneyland safe?

It's safe for those vaccinated for measles. For the unvaccinated -- not so much. All theme parks where there are international visitors pose a risk for the unvaccinated.

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Delay in diagnosis of measles compounds the spread, makes containing the outbreak more difficult.

Sometimes even after the onset of the measles rash, there's a delay in diagnosis, Harriman says

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The measles virus can hang suspended in the air. A person can sneeze on one side of a basketball court and someone on the other side of the court can catch the virus. (Chavez)

1/21/2015 10:19:16 PMAmy.Hubbard

In 2 1/2 weeks of 2015, there are as many measles cases in California as there were in all of 2014.

Chavez says in California in 2014 there were 61 cases. Now there are already 59 cases for 2015.

1/21/2015 10:19:52 PMAmy.Hubbard

Health care officials said it is safe to go Disneyland andother venues with large crowds if you are immunized for measles. “I think it isabsolutely safe for you to go to Disneyland if you’re vaccinated,” said Dr. GilChavez, the state epidemiologist.

But he cautioned that people who are too young to be immunized – such as infants less than 6 months of age – avoid large crowds where international travelers are concentrated, like theme parks and airports. “I would recommend that infants are not taken to places likeDisneyland today,” Chavez said.

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People born before 1957 are presumed to be immune, having had the disease as children. Those born after 1963 likely had at least one dose. But without a second dose, those people are vulnerable to the disease.

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Question: Is measles now going to circulate in the state normally?

Harriman answers she doesn't think it will become endemic in California at all ... "I think we will control it"

1/21/2015 10:24:14 PMAmy.Hubbard

Chavez says access to vaccination is not a problem in California. "Anyone who needs the measles vaccine should be able to get it. ..."The issue is people who opt not to get vaccinated by choice."

1/21/2015 10:28:22 PMAmy.Hubbard

It takes about two weeks after the vaccine to be safe for exposure to the disease.

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A medical team at Disney has been "very proactive" in identifying which of their employees may be susceptible to measles.

"They are concerned" with ending the outbreak, epidemiologist Chavez says

1/21/2015 10:33:23 PMAmy.Hubbard

Harriman: Of California's measles cases, six people are under 1 year old, seven are between ages 1 and 4 and six are between 5 and 19 years old.

1/21/2015 10:34:42 PMAmy.Hubbard

Chavez: For the time being, if you are not vaccinated or have an infant too young to be vaccinated, you should avoid Disneyland.